Working with young survivors of refugee trauma & torture [2012]

What have refugee young people experienced?

Young people who arrive in Australia as refugees or are from refugee-like situations have often had little choice in their migration. Rather it has been forced as a consequence of war or their persecution as members of particular ethnic, religious or social group. Most refugee young people will have been subjected to or have witnessed horrifying and traumatic events.

These may include:

War, bombing or shelling

Destruction of homes and schools

Violent death or injury of family or friends

Separation from family members

Sudden disappearances of family members or friends

Physical injury and limited medical attention

Deprivation of food, safe water and other resources essential for survival

Fear of discovery or arrest

Arrest, detention or torture

Forced conscription into armies or militias

Rape or sexual assault

Denial of opportunities for play.

All will have experienced some degree of loss of home, place, culture, as well the profound losses of parents, siblings, friends and significant others through death or separation.

What is the impact of resettlement?

On arrival in the new country young people are faced with learning a new language, adapting to a new set of cultural norms, and orienting themselves to many new systems such as the health and schooling system.

Many experiences in the new country can create new or ongoing traumas for the young people such as:

Ongoing danger in country of origin

New unfamiliar environments

Fear about the future and not coping

Continuing separation from family

Isolation and a sense of not belonging

Devaluing of the person in new culture

Injustice

Exposure to ignorance and lack of understanding

Racial prejudice

New humiliations

Australian Immigration Detention centres

Asylum seeking process/visa processing.

What is the impact of this experience?

The impact of the above experiences can be broken into four broad areas of trauma reaction:

1. Anxiety

Intrusive and recurrent distressing recollections of the traumatic event such as recurrent memories, images, nightmares of trauma and flashbacks

Impairment in ability to think, concentrate and remember

Conditioned fear response to reminders, places, things and people's behaviours leading to avoiding fearful situations, restriction of imaginative play and emotional withdrawal

Generalised fear not directly related to trauma such as fear of strangers, fear of being alone and fear of dark places

Hyper-vigilance or watchfulness

Reacting with startle to sudden changes in environment such as noise

Capacity to manage tension and frustration may be reduced leading to reduced control over impulsive behaviour

Emotional numbing leading to denial, detachment, reduced interest in activities and people

3. Shattered core assumptions about human existence

Previous expectations and dreams of future changed and need to build new outlook

Adolescents may be more alert to issue of human accountability

Heightened sensitivity to injustice

Impact on moral concepts. Behaviour is either overly regulated by considerations of what is good or bad or alternatively without consideration of good or bad

Loss of faith in adult's ability to protect

Loss of continuity of the self or impact on developing self-concept.

4. Shame and Guilt

Preoccupation with feelings of having failed to do something more to avert violence

Use of fantasy to exact revenge and repair damage done during traumatic event

Self-destructive behaviour

Avoidance of others due to shame

Inhibited experience of pleasure

Self-blame expressed as self-derogatory

Altered sense of self as being, feeling "dirty" or "bad".

How can I assist refugee young people?

When working with a young person who has experienced refugee trauma it is easy to feel overwhelmed. Often we see the many things that could be done to support the young person but find it hard to come to terms with what "I", the worker, can actually achieve for the young person. It is important to remember that "recovery" from trauma is the journey of the young person. We must remember that we will only travel on part of that journey with the young person and they will continue on. For this reason, it is important that case-management and partnership development be central to our work with the young person as this will assist the young person to develop a new network of support in Australia.

Having identified that we have a contribution to make, we then need to identify what skills we will use and what strategies will assist. The following list of strategies relate to the four areas of trauma reaction listed above. Four broad recovery goals are identified and example strategies given. The goals can be used as questions to assist you to reflect on your previous work with a young person and to assist you to plan for the future. Eg. "How have I assisted the young person to restore safety in their life?" and in the future "What could I be doing to assist the young person to restore safety?"

1. Restore safety and enhance control and reduce the disabling effects of fear and anxiety